Complex Regional Pain Syndrome Mandan ND

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Complex Regional Pain Syndrome

A Patient's Guide to Pain Management: Complex Regional Pain Syndrome

Introduction

Complex Regional Pain Syndrome (CRPS) is divided into two categories, CRPS I and CRPS II. CRPS I (caused by an injury to tissues) was previously called Reflex Sympathetic Dystrophy (RSD), Sudeck’s atrophy, and shoulder-hand syndrome. CRPS II (caused by damage to a nerve) was previously called causalgia. The symptoms and treatments of the two types are almost identical. For the purpose of this document we will refer to them jointly as CRPS. Early recognition of the signs and symptoms of CRPS as well as early treatment are usually effective in preventing it from becoming a chronic condition. When the condition becomes chronic, significant irreversible disability can occur.

This guide will help you understand

what parts of the body are involved

what causes this condition

how doctors diagnose the condition

what treatment options are available

Anatomy

What parts of the body are involved?

The sympathetic nervous system consists of ganglia, nerves and plexuses (a braid of nerves) that supply the involuntary muscles. Most of the nerves are motor, but some are sensory.

Sympathetic nerves are responsible for conducting sensation signals to the spinal cord from the body. They also regulate blood vessels and sweat glands. Sympathetic ganglia are collections of these nerves near the spinal cord. They contain approximately 20,000-30,000 nerve cell bodies.

CRPS is felt to occur as the result of stimulation of sensory nerve fibers. Those regions of the body rich in nerve endings such as the fingers, hands, wrist, and ankles are most commonly affected. When a nerve is excited, its endings release chemicals. These chemicals cause vasodilation (opening of the blood vessels). This allows fluid to leak from the blood vessel into the surrounding tissue. The result is inflammation or swelling leading to more stimulation of the sensory nerve fibers. This lowers the pain threshold. This entire process is called neurogenic inflammation. This explains the swelling, redness, and warmth of the skin in the involved area initially. It also explains the increased sensitivity to pain.

As the symptoms go untreated, the affected area can become cool, have hair loss, and have brittle or cracked nails. Muscle atrophy or shrinkage, loss of bone density (calcium), contracture, swelling, and limited range of motion in joints can also occur in the affected limb. These are in part caused by decreased blood supply to the affected tissues as the condition progresses.

Causes

What causes this condition?

CRPS commonly occurs after an injury as minor as having blood drawn, or a sprained ankle. Other times, it may be the result of a more significant injury such as surgery, a fracture, immobilization with casting or splinting, or the result of a stroke.

Risk factors for developing CRPS include immobilization of the affected limb with ...

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